Lumbar Rhizotomy is a minimally invasive surgical procedure to cut the sensory nerve roots which innervate the facet joints in the lower back. This pain relief procedure is indicated in patients who have previously felt short term relief from a facet joint or medial branch joint injection. If they have had pain relief and it returns then this procedure offers a more longer term solution to lumbar facet joint pain. The procedure disables the sensory nerve permanently therefore pain from arthritis of the facet joint can no longer be felt by the brain.

Who is a candidate for the procedure ?

Patients with lower back pain who have responded favorably to lumbar facet joint or medial branch joint injections. Typical signs of a lumbar facet joint pain is lower back pain which worsens with standing and increased pain on examination with extension and lateral bending of the spine.

Medical Indications:

• 2 separate positive medial branch blocks with > than 80% relief of pain,
• Axial lower back pain
• A diagnosis of Lumbar Spondylosis with facet arthritis or degenerative disc disease

Potential Benefits of the Procedure

• Out patient procedure
• Short Procedure times
• Minimally invasive procedure
• Minimal incision
• Can treat multiple facet joints
• Quick relief of symptoms
• Prevent having surgery with large open incisions.

Prior to the Procedure

• Physical exam and diagnostic testing of MRI should be conducted.
• Patient has failed conservative care including medications, physical therapy, or spinal facet joint injection therapy.

During the Procedure

The Endoscopic Disc system require the patient to lie prone on their stomach. Minimal anesthesia with IV sedation may be necessary. A needle is inserted into the skin near the affected facet joint level, followed by an incision through which a slightly (larger than the needle) hollow tube is placed. An endoscope camera is inserted by which water is used to help visualize the tissue and nerves. Once the sensory nerve anatomy region is identified a probe is inserted thru the camera and using an electrified heated probe technology the nerve is severed. At the conclusion of the procedure, steroid is injected, the tube is removed and a small bandage is applied. A stitch or derma-bond glue may be used to seal the area.

After the Procedure

Patients are required to remain at the facility for 30 minutes to an hour for recovery. Upon release, patients are driven home by the surgery center. Patient should rest for one to three days with limited standing and walking. There may be soreness or bruising at the site of the procedure for up to a week. In most cases, symptoms caused by the lumbar facet joint are gone or decreased within two weeks. After one week of the procedure, patient should return back to physical therapy, which is important for full recovery. Patient can return to work after 3-5 days depending upon the patient’s recovery.

Are There any Complications With the Procedure ?

As with any minimally invasive treatments, side effects of the procedure are relatively rare. This is very safe pain relief procedure because patients are monitored with live nerve monitoring to ensure the safety of the patient and prevent any complications.